实用医学杂志 ›› 2023, Vol. 39 ›› Issue (4): 456-459.doi: 10.3969/j.issn.1006⁃5725.2023.04.012

• 临床研究 • 上一篇    下一篇

内镜下金属止血夹联合埃索美拉唑治疗 Forrest Ⅱb级急性非静脉曲张性消化道出血的效果及经济效益分析 

秦青 沈翔 王伟 吴水梅    

  1. 芜湖市第一人民医院消化内科(安徽芜湖 241000)

  • 出版日期:2023-02-25 发布日期:2023-02-25
  • 基金资助:
    芜湖市科技计划项目(编号:2012hm32⁃2)

Clinical study and economic benefit analysis of endoscopic metal hemostatic clip combined with esomepra⁃ zole in treatment of Forrest Ⅱb acute non ⁃ variceal upper gastrointestinal bleeding

QIN Qing,SHEN Xiang,WANG Wei,WU Shuimei.   

  1. Department of Gastroenterology,Wuhu First People′s Hospital,Wuhu 241000 China

  • Online:2023-02-25 Published:2023-02-25

摘要:

目的 评估内镜下金属止血夹联合埃索美拉唑治疗 Forrest Ⅱb 级急性非静脉曲张性上消化 道出血(NVOGIB)的疗效,并分析该联合疗法的经济效益。方法 回顾性分析 48 例经内镜下金属止血 夹联合埃索美拉唑治疗的 Forrest Ⅱb NVOGIB 患者临床资料(联合组),并将经性别、年龄等基线资料 1∶1 匹配的 48 例埃索美拉唑治疗的 Forrest Ⅱb NVOGIB 患者作为对照组。记录两组临床疗效、病情 转归情况(输血率、住院时间、7 d 再出血率)及不良反应发生情况,比较两组治疗 1 个月后黏膜愈合情 况(再生黏膜成熟度及组织学再生黏膜成熟度),并对两种治疗方案行成本⁃效果分析。结果 联合组 临床疗效显著高于对照组(P < 0.05),住院时间则显著低于对照组(P < 0.05)。两组输血率、7 d 再出血 率及不良反应发生情况比较,差异无统计学意义(P > 0.05)。治疗 1 个月后,联合组再生黏膜成熟度、组 织学再生黏膜成熟度均优于对照组(P < 0.05)。联合组成本高于对照组(P < 0.05),但联合组成本- 果比为 91.45,低于对照组的 97.07;与联合组相比,对照组每增加 1 个单位治疗总有效率,需要增加费用 52.15 元。结论 内镜下金属止血夹联合埃索美拉唑治疗 Forrest Ⅱb NVOGIB 效果显著,安全可靠,且 更经济。

关键词:

急性非静脉曲张性上消化道出血, Forrest Ⅱb, 内镜, 金属止血夹, 埃索美拉唑, 经济效益

Abstract:

Objective To evaluate the efficacy of endoscopic metal hemostatic clip combined with esome⁃ prazole in the treatment of Forrest Ⅱb acute non⁃variceal upper gastrointestinal bleeding(NVOGIB),and analyze the economic benefit of the combined therapy. Methods The clinical data of 48 patients with Forrest Ⅱb NVOGIB who were treated with endoscopic metal hemostatic clip combined with esomeprazole were retrospectively analyzed (combined group),and 48 patients with Forrest Ⅱb NVOGIB by a 1:1 match of baseline data such as gender and age treated with someprazole were selected as control group. Clinical efficacy,disease outcomes(blood transfusion rate,hospital stay,7⁃day re⁃bleeding rate)and occurrence of adverse reactions were recorded in the two groups. The mucosal healing status(reproductive mucosal maturity and histological reproductive mucosal maturity)were compared between the two groups after 1 month of treatment. The cost ⁃effectiveness analysis of the two treatment regimens was performed. Results The clinical efficacy of the combined group was significantly higher than that of the control group(P < 0.05),and the hospital stay was significantly shorter than that of control group(P < 0.05). There were no statistical differences in blood transfusion rate,7⁃day re⁃bleeding rate and occurrence of adverse reactions between the two groups(P > 0.05). After 1 month of treatment,the reproductive mucosal maturity and histological regenerative mucosal maturity of combined group were better than those of the control group(P < 0.05). There was higher cost in the combined group(P < 0.05),but the cost⁃effectiveness ratio of 91.45 in combined group was lower than that of 97.07 in the control group. The total effective rate of treatment for every additional unit in the control group needed increased cost of 52.15 yuan compared to combined group. Conclusion Endoscopic metal hemostatic clip combined with esomeprazole has a significant effect in the treatment of Forrest Ⅱb NVOGIB,and it is safe and more economical.

Key words:

acute non ?variceal upper gastrointestinal bleeding, Forrest Ⅱb, endoscopic, metal hemostatic clip, esomeprazole, economic benefit